A Vall d'Hebron study shows underuse of lung transplantation in patients with pulmonary arterial hypertension

Based on data from the Spanish Pulmonary Arterial Hypertension Registry (REHAP), a team of professionals led by Dr. Manuel López-Meseguer, of the Pneumology Service of Vall d'Hebron Hospital, has studied the use of lung transplantation in patients with this disease. The analysis of 1391 patients has led them to conclude that there are few who can benefit from this technique due to the strict selection criteria. Even so, half of the patients potentially eligible for transplants do not access it. The study has been published in the journal PLOS One.

Between January 2007 and March 2015, a total of 1,391 patients with Pulmonary Arterial Hypertension (PAH) were included in REHAP, of which 375 (27%) died and 36 (3%) were transplanted in that period. It was estimated that, within the group of deceased patients, 36 were potentially eligible for lung transplantation, despite which they did not opted for it.

Therefore, these data show the underutilization of lung transplantation in patients with PAH, since "it is probable that almost twice as many patients could have benefited from this option," warns Dr. Manuel López-Meseguer. "This situation," says Dr. Antonio Román, head of the Pulmonary Transplant Unit of the Vall d'Hebron Hospital-could be optimized if the referral of patients to centres that have a lung transplant program in the early stages of the disease is expedited."

However, the researchers note that, as with other respiratory diseases, the use of lung transplantation as a treatment for PAH is restricted to very selected cases, and even under ideal conditions, only a small number of patients receive it.

In fact, the study has revealed that patients who are treated in hospitals where lung transplants are done, would have more chances of being transplanted than if they are treated in other centres.

In Spain, there are only seven hospitals that have a lung transplant program, Vall d'Hebron being a reference in this field and also in the treatment of pulmonary arterial hypertension.

Pulmonary Arterial Hypertension

PAH is a rare, serious and life-threatening disease caused by high blood pressure in the pulmonary arteries, which narrows making blood flow in its path difficult. Among the most common symptoms are fatigue in routine activities and dyspnoea or shortness of breath. The worsening can be very fast and the outcome fatal. In fact, among those affected, every year there is a mortality rate of 19%. Therefore, lung transplantation should be considered in cases of severe HAP that show an insufficient response to pharmacological treatment.